5 Things Pharmacists Should Know About the Recent Salmonella Outbreak

The CDC is currently investigating an outbreak of Salmonella infections linked to raw turkey products. Laboratory studies have revealed that the strain is known as Salmonella Reading, and has been identified in samples taken from raw turkey pet food, raw turkey products, and live turkeys.¹ Pharmacists can play an important role in educating patients on Salmonella infection prevention strategies.

Here are 5 things pharmacists should know about the recent Salmonella outbreak:

1. Ninety cases have been reported across 26 states.¹ As of July 11, 2018, 90 cases of Salmonella infection that have been reported across 26 states.¹ While no deaths have been reported, 40 individuals have been hospitalized. Illnesses began from November 20, 2017 to June 29, 2018 with an age range of less than 1 year to 91 years.¹ It is important to keep in mind that cases may increase as reporting can be delayed. Unfortunately, a single common supplier of raw turkey products or of live turkeys has not been identified at this time, but is still under investigation.

2. Symptoms usually develop within 12-72 hours of exposure. Individuals typically develop diarrhea, fever, and abdominal cramps within 12-72 hours after infection. According to the CDC, Salmonella causes about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the United States each year.²

3. The PulseNet system is being utilized to identify infections.¹ PulseNet is a national laboratory network which began in 1996 that connects foodborne illness cases to identify outbreaks. This unique system is coordinated by the CDC through DNA fingerprinting using pulsed-field gel electrophoresis and whole genome sequencing (WGS) of bacteria causing illness to help investigators, and researchers identify the source of infections, and alert the public.

4. The Salmonella infection is resistant to ampicillin. There were 33 isolates from ill individuals, and 49 isolates from food and animal samples identified through WGS that contained genes resistant to the following antibiotics: ampicillin, streptomycin, sulfamethoxazole, tetracycline, gentamicin, and kanamycin.¹ Ampicillin is considered a treatment option for Salmonella infections, but other options include fluoroquinolones, and third-generation cephalosporins.² Antibiotic resistance is common for Salmonella infections. Pharmacists can educate other healthcare professionals that antibiotics should be reserved for patients with severe disease or those at high risk for complications (e.g. infants, adults over 65 years of age, immunocompromised individuals). In healthy patients, the illness typically lasts for about 4-7 days with just fluids.²

5. Safe food practices are important to prevent illness. Pharmacists can educate patients on the importance of safe food practices with raw turkey products to prevent Salmonella infections. Individuals should wash their hands before and after preparing or eating food, and after contact with animals. Raw turkey should be cooked thoroughly to an internal temperature of 165°F to kill harmful bacteria.¹ Additionally, raw pet food, such as raw turkey products, that are even packaged and sold in stores should not be given to animals as it can cause Salmonella infection. Individuals handling raw pet food can also become infected with Salmonella.

References:

• Centers for Disease Control and Prevention. Outbreak of multidrug-resistant Salmonella infections linked to raw turkey products. CDC website. www.cdc.gov/salmonella/reading-07-18/index.html. Accessed July 19, 2018.
• Centers for Disease Control and Prevention. Salmonella information for healthcare professionals and laboratories. CDC website. www.cdc.gov/salmonella/general/technical.html. Accessed July 19, 2018.